Robins H I, Longo W L, Steeves R A, Lagoni R K, Hugander A, Neville A J, O'Keefe S, Giese W, Schmitt C L
University of Wisconsin Clinical Cancer Center, Madison, WI 53792.
Int J Radiat Oncol Biol Phys. 1988 Aug;15(2):427-31. doi: 10.1016/s0360-3016(98)90025-6.
Six patients with Stage III non-small cell lung cancer completed therapy which consisted of 4 whole body hyperthermia (WBH) treatments during the first 2 weeks of a 6 week course of radiotherapy (60 Gy). A radiant heat system was used to deliver the 41.8 degree C WBH. To reduce the danger of transverse myelitis, the spinal cord (and therefore part of the mediastinum and contralateral hilar region) was not irradiated during the first 2 weeks of radiotherapy and concurrent WBH. Subsequent treatments (weeks 3-6) included conventional irradiation to the primary tumor, mediastinal lymph nodes and spinal cord. Areas of gross disease responded to therapy in 5/6 patients. No radiation pneumonitis was observed. In 2/6 patients, relapse (after 10 months and 6 months, respectively) occurred with malignant pericardial effusions. The mediastinum in these patients was not an area of bulky disease involvement initially. To eliminate such WBH-radiation sanctuary zones, the protocol was modified to include greater combined WBH-radiation treatment. This is accomplished by having one WBH treatment "sandwiched" between 2 radiation fractions. The preclinical basis for the revised protocol is presented.
6例III期非小细胞肺癌患者完成了治疗，该治疗包括在为期6周的放疗疗程（60 Gy）的前2周内进行4次全身热疗（WBH）。使用辐射热系统进行41.8摄氏度的全身热疗。为降低横贯性脊髓炎的风险，在放疗的前2周以及同步全身热疗期间，脊髓（以及部分纵隔和对侧肺门区域）未接受照射。后续治疗（第3 - 6周）包括对原发肿瘤、纵隔淋巴结和脊髓进行常规照射。6例患者中有5例大体病变区域对治疗有反应。未观察到放射性肺炎。2例患者分别在10个月和6个月后出现伴有恶性心包积液的复发。这些患者的纵隔最初并非大块病变累及区域。为消除此类全身热疗 - 放疗庇护区，修改了方案以增加全身热疗与放疗的联合治疗。这通过在2次放疗疗程之间“夹入”1次全身热疗来实现。本文介绍了修订方案的临床前依据。
